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Biologic-treated Psoriasis has Less Progression to Psoriatic Arthritis

A single center study demonstrates that biologic treatment of psoriasis (PsO) significantly reduces the likelihood of psoriatic arthritis (PsA) development; suggesting a role for more aggressive treatment of PsO. 

A monocentric study of 1023 PsO patients found those treated at least once with biologics had a significantly lower risk of developing PsA, compared to patients never treated with biologics (8.9% vs 26.1%, P < 0.001).  In multivariate analysis, these findings were still significant (P < 0.01) with a 77% reduced risk (adjusted odds ratio [adjOR] 0.228), of developing PsA.

These findings applied to the use of the following biologics targeting: 

  • TNF (adjOR 0.206) 
  • IL-17 (adjOR 0.051) 
  • IL-23 or 12/23 (adjOR 0.167)

PsO patients treated with biologics also had a significantly (P < 0.04) lower prevalence of peripheral PsA (adjOR 0.182) and peripheral PsA with axial involvement (adjOR 0.115).

Similar findings have been reported elsewhere, but also have been refuted for channeling bias and calls for a rigorous poppulation based analysis of this question.


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The author has no conflicts of interest to disclose related to this subject